Patient Forms

Pediatric Dentistry of Palo Alto

Streamlining Your Visit for Convenience and Care

At Pediatric Dentistry of Palo Alto, we strive to make your experience as seamless and stress-free as possible, starting with the very first step of your visit. To ensure we can provide the best care right from the start, we kindly ask our families to complete several forms prior to their appointment. This preparation helps us to understand your child’s health background, streamline the check-in process, and dedicate more time to your child’s care during your visit.

Available Forms for Download

Below, you’ll find a list of our patient forms that can be easily downloaded, filled out, and brought with you to your child’s first appointment. Completing these forms in advance allows us to focus on what matters most — your child’s smile and well-being.

New Patient Form

Welcome to our family! This form gathers essential information about your child and your family, helping us get to know you better and tailor our care to your child’s needs.

Health History Form

Welcome to our family! This form gathers essential information about your child and your family, helping us get to know you better and tailor our care to your child’s needs.

Primary Insurance Info

Welcome to our family! This form gathers essential information about your child and your family, helping us get to know you better and tailor our care to your child’s needs.

COVID-19 Questionnaire

Welcome to our family! This form gathers essential information about your child and your family, helping us get to know you better and tailor our care to your child’s needs.

Auth. For Release

Welcome to our family! This form gathers essential information about your child and your family, helping us get to know you better and tailor our care to your child’s needs.